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Diverse interconnections between macrophage migration inhibitory issue and psychological issues.
Results The majority of 312 patients were Hispanic (62.5%), 18.1% were less then 50 years, and 81.9% were ≥ 50 years of age (median age, 57 years). Of patients with CRC screened for LS via IHC, the PRE, PERI, and POST cohorts had screening rates of 31%, 64%, and 58%, respectively. We found significant differences when comparing the PRE with POST sequential cohorts (P less then .01). Conclusion The quality of Lynch syndrome-related family histories and screening rates were significantly improved after implementation in our Hispanic-rich population. Future studies are warranted to provide insight into clinical effects of increased screening, provider and patient surveillance, and screening-related systemic barriers.Background Preterm mothers face unique challenges-the stress of preterm delivery and their premature babies' inability to suckle directly from the breasts, culminating in poor milk supply. Galactogogues are substances believed to enhance human milk production. Evidence for their use in preterm mothers is insufficient. Research aims To (a) evaluate the influence of galactogogues on milk production among mothers with preterm birth, and (b) assess the safety of galactogogues for mother-infant dyads. Methods A systematic search was conducted between January 2018 and May 2019 in nine electronic databases, with manual searches through reference lists of included articles. Randomized controlled trial studies addressing outcome measure of milk quantification were selected. Seven trials met the inclusion criteria and, using the Clinical Appraisal Skills program checklists and the modified Cochrane Collaboration tool for assessing risk of bias, each trial was critically appraised for content, bias in methodology, and reporting. Results Four herbal substances (fenugreek, silymarin, silymarin/galega, and stinging nettle) and domperidone used in intervention studies were analyzed. Fenugreek and silymarin used in isolation did not yield significant increase in milk production, while the combination herbal mixtures silymarin/galega and stinging nettle herbal tea increased milk production. Domperidone use resulted in an acute increase in milk production, which was not sustained with prolonged use. The reviewed studies reported no serious adverse effects on mother-infant dyads. Conclusion Herbal galactogogues may be more effective for longer term use, although there is still limited evidence to support its prescription to preterm mothers. Larger studies are required.Objective Characterize the survival impact of smoking on HPV-related (human papillomavirus) oropharyngeal squamous cell carcinoma. Data sources Articles from 2000 to 2019 in the PubMed, Embase, and Cochrane Library databases were systematically reviewed for content and inclusion/exclusion criteria. Review methods Two reviewers independently analyzed the databases for eligibility and quality of the articles. Demographic data, smoking history, and survival outcomes were recorded. Hazard ratios and 95% CIs were collectively analyzed through a random effects meta-analysis model. Results Fifteen articles were included in the meta-analysis for overall survival, disease-specific survival, disease-free survival, progression-free survival, and locoregional recurrence outcomes. The overall survival hazard ratio was 2.4 for ever having smoked (95% CI, 1.4-4.0; P = .0006, I2 = .384) and 3.2 for current smoking (95% CI, 2.2-4.6; P less then .0001, I2 = 0). The hazard ratio for disease-specific survival in current smokers was 6.3 (95% CI, 1.3-29.3; P = .0194, I2 = 0). Ever smoking had a larger impact on overall survival and disease-specific survival than the 10-pack year smoking threshold. Conclusion Smoking negatively affects survival in patients with HPV-related oropharyngeal carcinoma across all outcomes. Current smoking during treatment is associated with the greatest reduction in survival, possibly secondary to diminished radiation therapy efficacy.Few researches have been focused on the treatment delay of rural-to-urban migrants in China. Our study aimed to investigate the effect of migration duration on treatment delay among rural-to-urban migrants in tertiary hospitals. A cross-sectional study was conducted based on a sample of 727 patients and surveyed factors including sociodemographics, medical costs, migration, treatment delay, and health cost-coping strategies. Totally, 727 patients were included, of which 61 delayed their treatment and 666 had no treatment delay. Statistically significant differences were found between different migration duration groups in marital status, education, insurance, family annual income, residency, payment before treatment, reported disease, and migration duration (P less then .05). The results from multiple logistic regression showed that migration between 1 and 5 years (adjusted odds ratio [OR] = 7.24; 95% confidence interval [CI] = 1.59-32.87; P less then .05) was considered the significant contributing risk factor for treatment delay after adjusting for age, sex, and other variables. To cope with their health expenditure, patients with treatment delay tended to use less savings and borrow more money than those without. Rural-to-urban migrants with 1 to 5 years of migration were the most vulnerable group of having treatment delay. Migrants were more likely to borrow money to cope with the health expenditure. Targeted services should be provided to meet different needs of migrants according to migration duration.Objective In the era of SARS-CoV-2, the risk of infectious airborne aerosol generation during otolaryngologic procedures has been an area of increasing concern. The objective of this investigation was to quantify airborne aerosol production under clinical and surgical conditions and examine efficacy of mask mitigation strategies. Study design Prospective quantification of airborne aerosol generation during surgical and clinical simulation. Setting Cadaver laboratory and clinical examination room. Subjects and methods Airborne aerosol quantification with an optical particle sizer was performed in real time during cadaveric simulated endoscopic surgical conditions, including hand instrumentation, microdebrider use, high-speed drilling, and cautery. Aerosol sampling was additionally performed in simulated clinical and diagnostic settings. All clinical and surgical procedures were evaluated for propensity for significant airborne aerosol generation. Results Hand instrumentation and microdebridement did not producdard surgical masks did not.Background Better understanding of the molecular biology associated with MRI phenotypes may aid in the diagnosis and treatment of breast cancer. Purpose To discover the associations between MRI phenotypes of breast cancer and their underlying molecular biology derived from gene expression data. Materials and Methods This is a secondary analysis of the Multimodality Analysis and Radiologic Guidance in Breast-Conserving Therapy, or MARGINS, study. MARGINS included patients eligible for breast-conserving therapy between November 2000 and December 2008 for preoperative breast MRI. Tumor RNA was collected for sequencing from surgical specimen. Twenty-one computer-generated MRI features of tumors were condensed into seven MRI factors related to tumor size, shape, initial enhancement, late enhancement, smoothness of enhancement, sharpness, and sharpness variation. These factors were associated with gene expression levels from RNA sequencing by using gene set enrichment analysis. Statistical significance of these assng the ribosome. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Cho in this issue.Background Deep learning may help to improve computer-aided detection of volume (CADv) measurement of pulmonary nodules at chest CT. Purpose To determine the efficacy of a deep learning method for improving CADv for measuring the solid and ground-glass opacity (GGO) volumes of a nodule, doubling time (DT), and the change in volume at chest CT. Materials and Methods From January 2014 to December 2016, patients with pulmonary nodules at CT were retrospectively reviewed. selleck chemical CADv without and with a convolutional neural network (CNN) automatically determined total nodule volume change per day and DT. Area under the curves (AUCs) on a per-nodule basis and diagnostic accuracy on a per-patient basis were compared among all indexes from CADv with and without CNN for differentiating benign from malignant nodules. Results The CNN training set was 294 nodules in 217 patients, the validation set was 41 nodules in 32 validation patients, and the test set was 290 nodules in 188 patients. A total of 170 patients had 290 nodulesy nodules. © RSNA, 2020 Online supplemental material is available for this article.Background Dual-energy CT allows virtual noncontrast (VNC) attenuation and iodine density measurements from contrast material-enhanced examination, potentially enabling adrenal lesion characterization. However, data regarding diagnostic performance remain limited, and combined diagnostic values have never been investigated. Purpose To determine whether VNC attenuation, iodine density, and combination of the two allow reliable differentiation between adrenal adenomas and metastases. Materials and Methods This retrospective study included patients with adrenal lesions who underwent unenhanced and portal venous phase dual-energy CT between January 2017 and December 2018. Unenhanced, contrast-enhanced, and VNC attenuation, as well as iodine density, were measured for each lesion. Agreement between unenhanced and VNC attenuation was assessed by using Wilcoxon rank-sum test, Pearson correlation coefficient, and Bland-Altman plot. The ratio of iodine density to VNC attenuation was calculated for lesions with positiv, 0.54; 95% CI 0.45, 0.62). Iodine density yielded moderate performance (sensitivity of 78% [80 of 102] [95% CI 69%, 86%] and specificity of 71% [40 of 56] [95% CI 58%, 83%], with a threshold of ≥1.82 mg/mL). The iodine-to-VNC ratio was higher in adenomas than in metastases (mean, 14.5 vs 4.6; P less then .001), with sensitivity of 95% (97 of 102; 95% CI 89%, 98%) and specificity of 95% (53 of 56; 95% CI 85%, 99%), with a threshold of 6.7 or greater. Conclusion Contrast-enhanced dual-energy CT during the portal venous phase enabled accurate differentiation between adrenal adenomas and metastases by combining virtual noncontrast attenuation and iodine density. Virtual noncontrast imaging alone led to overestimates of adenoma attenuation, and iodine density alone had limited discriminatory utility. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Hindman and Megibow in this issue.Background Gadoxetic acid is classified by the American College of Radiology as a group III gadolinium-based contrast agent (GBCA), which indicates that there are limited data regarding nephrogenic systemic fibrosis (NSF) risk, but there are few if any unconfounded cases of NSF. Purpose To perform a systematic review and meta-analysis of gadoxetic acid adverse events, including immediate hypersensitivity reactions, NSF, and intracranial gadolinium retention. Materials and Methods Original research studies, case series, and case reports that reported adverse events in patients undergoing gadoxetic acid-enhanced MRI were searched in MEDLINE (1946-2019), Embase (1947-2019), CENTRAL (March 2019), and Scopus (1946-2019). The study protocol was registered at Prospero (number 162811). Risk of bias was evaluated by using Quality Assessment of Diagnostic Accuracy Studies-2, or QUADAS-2. Meta-analysis of proportions was performed by using random-effects modeling. Upper bound of 95% confidence interval (CI) for risk of NSF was determined.
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